Management of critical care emergencies in children with autism spectrum disorder

Mohammed Al-Beltagi; Nermin Kamal Saeed; Adel Salah Bediwy; Rawan Alhawamdeh; Reem Elbeltagi

doi:10.5492/wjccm.v14.i2.99975

Management of critical care emergencies in children with autism spectrum disorder

World J Crit Care Med. 2025 Jun 9;14(2):99975. doi: 10.5492/wjccm.v14.i2.99975.

Authors

Mohammed Al-Beltagi^{1

2}, Nermin Kamal Saeed^{3

4}, Adel Salah Bediwy^{5

6}, Rawan Alhawamdeh^{7

8}, Reem Elbeltagi⁹

Affiliations

¹ Department of Pediatric, Faculty of Medicine, Tanta University, Tanta ‎ 31511‎, Alghrabia, Egypt.
² Department of Pediatric, University Medical Center, King Abdulla Medical City, Arabian Gulf University, Manama 26671, Manama, Bahrain. mbelrem@hotmail.com.
³ Medical Microbiology Section, Department of Pathology, Salmaniya Medical Complex, ‎Ministry of Health, Kingdom of Bahrain, Manama 26671, Manama, Bahrain.
⁴ Medical Microbiology Section, Department of Pathology, Irish Royal College of Surgeon, Bahrain, Busaiteen 15503, Muharraq, Bahrain.
⁵ Department of Pulmonology, Faculty of Medicine, Tanta University, Tanta ‎‎ 31527, Alghrabia, Egypt.
⁶ Department of Pulmonology, University Medical Center, King Abdulla Medical City, Arabian Gulf University, Manama 26671, Manama, Bahrain.
⁷ Department of Pediatrics Research and Development, Sensoryme Dwc-llc, Dubai 712495, Dubai, United Arab Emirates.
⁸ Department of Pediatrics Research and Development‎, Genomics Sensory Play and Creativity Center, Manama 22673, Manama, Bahrain.
⁹ Department of Medicine, The Royal College of Surgeons in Ireland-Bahrain, ‎Busiateen 15503, Muharraq, Bahrain.

Abstract

Background: Managing critical care emergencies in children with autism spectrum disorder (ASD) presents unique challenges due to their distinct sensory sensitivities, communication difficulties, and behavioral issues. Effective strategies and protocols are essential for optimal care in these high-stress situations.

Aim: To systematically evaluate and synthesize current evidence on best practices for managing critical care emergencies in children with ASD. The review focuses on key areas, including sensory-friendly environments, communication strategies, behavioral management, and the role of multidisciplinary approaches.

Methods: A comprehensive search was conducted across major medical databases, including PubMed, Embase, and Cochrane Library, for studies published between 2000 and 2023. Studies were selected based on their relevance to critical care management in children with ASD, encompassing randomized controlled trials, observational studies, qualitative research, and case studies. Data were extracted and analyzed to identify common themes, successful strategies, and areas for improvement.

Results: The review identified 50 studies that met the inclusion criteria. Findings highlighted the importance of creating sensory-friendly environments, utilizing effective communication strategies, and implementing individualized behavioral management plans. These findings, derived from a comprehensive review of current evidence, provide valuable insights into the best practices for managing critical care emergencies in children with ASD. Sensory modifications, such as reduced lighting and noise, visual aids, and augmentative and alternative communication tools, enhanced patient comfort and cooperation. The involvement of multidisciplinary teams was crucial in delivering holistic care. Case studies provided practical insights and underscored the need for continuous refinement of protocols.

Conclusion: The review emphasizes the need for a tailored approach to managing critical care emergencies for children with ASD. Sensory-friendly adjustments, effective communication, and behavioral strategies supported by a multidisciplinary team are integral to improving outcomes. Despite progress, ongoing refinement of care practices and protocols is necessary. This ongoing process addresses remaining challenges and engages healthcare professionals in continuous improvement of care for children with ASD in critical settings.

Keywords: Autism spectrum disorder; Behavioral management; Communication strategies; Critical care emergencies; Emergency protocols; Multidisciplinary approach; Pediatric intensive care; Sensory sensitivities.